My sweet boy, Ari, has had 2 shunt revisions, ETV placement and will be having a major skull reconstruction surgery in 2 months. He is still working on head control as well as feeding. He has overcome so much and he has so much further to go … without Medicaid he would not survive. Being a single parent, the support given through Medicaid help ensure that he will receive all the healthcare support that he so desperately needs. I work full time and have private insurance personally, he is also on my plan, but TEFRA helps allow for him to have continued therapy, the wheelchair that helps him participate in all community/school activities and surgeries that he needs to survive and thrive. His birthday is this week and I can’t believe he will be 4!!
Tag: parent
Catch up on the Provider Led Model (PASSE)
PASSE stands for Provider-owned Arkansas Shared Savings Entities, and this new Provider-led model is required by a law passed by the Arkansas State Legislature last spring. DHS has been told to achieve a certain amount of Medicaid cost savings, and the theory is that this model should achieve them through better management of care. Over the next year and a half, we will see a shift in the management of Medicaid care for certain recipients under the Developmental Disabilities Services and Behavioral Health Services Divisions of DHS through the implementation of this model.
During the transition time, each recipient will undergo an Independent Assessment to determine services given, and then each recipient will be assigned to one of the PASSEs. Right now, we don’t know how many PASSEs there will be or which partners each will include. That should all become clear after June 15, 2007. Once the recipient receives information about which PASSE he or she has been assigned to, he or she will have 90 days to switch to a new PASSE if desired. Everyone will be on a different timeline, so recipients won’t really be able to compare situations early on.
This transition will take place throughout 2017 and 2018 as PASSEs slowly take on responsibility. In 2019, the PASSEs will take on all responsibility of managing the care and funds for each recipient they’ve been assigned. Providers will then bill the PASSE for each client, which means that the providers have to participate in probably all PASSEs to be “in network” for their current clients and future clients.
As said before, this will only affect certain clients – classified as Tier 2 and Tier 3 – for both DD and BH. Tier 2 and 3 people are defined differently by DD and BH, but basically it’s determined by level of care needed.
As we’ve all seen, this is very complicated, and a lot of information has already been shared. Here’s your chance to catch up!
See DHS Presentations from public meetings that occurred in April 2017.
Read the law that was passed during this past spring session.
See DHS’s answers to your questions.
See in depth information from DHS about the PLM.
April 2017: Opportunities to Communicate!
A message from the Arkansas Provider Coalition:
Dear providers, beneficiaries, parents of beneficiaries, and other relevant stakeholders –
Beginning Monday, April 3, and continuing every Monday through April 24, DHS will resume large group meetings with stakeholders regarding the Behavioral Health and Developmental Disabilities client journey and transition of individuals into the Provider-Led Entity model. DHS will seek input from the key stakeholders regarding their roles and responsibilities to ensure the timely and effective launch of this initiative.
The meetings will be from 1:30 – 3:30 P.M., and will be held at St. Vincent Hospital’s Main Auditorium*.
The first meeting will focus on the population of beneficiaries with behavioral health needs and their client journey into the Provider Led Entity model. Our second meeting will focus on the developmentally disabled population and their client journey into the Provider-Led Entity model.
All are welcome to attend either in person, or via the web at: http://bit.ly/2mSKp9D You may register for all four meetings using the link above. If you are unable to attend the meetings in person or online, the sessions will be recorded and posted to the Arkansas Medicaid website (https://www.medicaid.state.ar.us/).
*The Main Auditorium is located in the Center for Education, which is directly across the street from the parking garage. There is a fountain in front of the entrance.
Medicaid Saves Lives 